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General NPI Number Information
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NPI Number | 1700380144
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Entity Type | Individual
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Provider Name | LAURA LYNN DELOACH COTA
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Gender | Female
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Dates
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Enumeration Date | 03/21/2018
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Last Update Date | 03/21/2018
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Provider Practice Location Address
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Address Line | 2564 FOX POINTE DR
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City | COLUMBUS
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State | IN
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Zip | 47203-3181
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Country | US
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Telephone | 866-962-7609
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Fax |
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Provider Business Mailing Address
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Address Line | 306 S MAIN ST
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City | EDINBURGH
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State | IN
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Zip | 46124-1339
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Country | US
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Telephone | 812-223-1087
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 32002174A
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License Number State | IN
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